The Overlooked Deficits of Acquired Brain Injury: Bringing Visual Rehabilitation into Focus

Each year, 2.5 million Americans experience a form of ABI, including TBI and stroke (Englehardt, Richman & Weiss, 2003). Visual impairments often co-occur post-ABI, with 25% of stroke survivors experiencing visual field cuts and 40% of people with a TBI experiencing vision impairment (Englehardt et al., 2003; Rowe et al., 2009). Although vision impairment post-ABI impacts rehabilitation outcomes and occupational performance, it is frequently overlooked by healthcare practitioners (Nelms, 2000). OTs are uniquely suited to address the impact of visual deficits on occupational performance. This systematic appraisal of the literature examines interventions to address visual deficits in individuals with ABI. PubMed, Ovid Medline, and CINAHL databases were searched using terms pertaining to visual impairment, ABI, visual rehabilitation, and occupational therapy. Inclusion criteria required that articles be peer-reviewed, Level I-V evidence, published between 2004 and 2014, included adult participants, and addressed outcomes related to daily functioning and participation. Exclusion criteria further refined the search to exclude articles that contained pharmaceutical or surgical interventions, populations Evaluation of Quality of an Intervention Study. Emerging evidence supports the use of OT visual rehabilitation interventions in clinical practice to improve functional performance in adults with ABI (Radomski, Davidson, Voydetich & Erickson, 2009). In order to provide ethical, evidence-based services, OTs and other clinicians must understand the increased incidence and complexity of visual deficits associated with ABI. Evidence emphasizes the importance of immediate visual evaluation and optometrist referrals followed by client-centered intervention for best patient outcomes (Englehardt et al., 2003). Reviewed articles highlighted the use of a variety of compensatory and remedial interventions including prism lenses (Carman-Merrifield, 2005), environmental modifications (Copolillo & Ivanoff, 2012), and oculomotor training (Kapoor, Ciuffreda, & Han, 2004). This review found promising preliminary evidence to support OT intervention for neurovisual deficits; however, more rigorous studies are needed to inform clinical practice. Presentation: 43 minute